JP2022037219A - Cough-assist systems with humidifier bypass - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a humidifier for a ventilation and cough-assist system.

SOLUTION: The present technology relates generally to cough-assist devices with humidified cough assistance. In one example, a system 10 includes a cough-assist device having a first phase configured to provide insufflating gas 112 to a patient circuit 110 and a second phase configured to draw exsufflating gas 113 from the patient circuit. A humidifier 141 is disposed between the cough-assist device and a distal end of the patient circuit, the humidifier including a chamber configured to contain heated water and fluidically coupled to the cough-assist device and the patient circuit. The system further includes a bypass 142 configured to (a) direct insufflating gas from the cough-assist device through a first route to the patient circuit such that the insufflating gas is humidified in the chamber and (b) route exsufflating gas from the patient circuit through a second route to the cough-assist device such that the exsufflating gas bypasses the chamber.

SELECTED DRAWING: Figure 1

COPYRIGHT: (C)2022,JPO&INPIT

Description

(Mutual reference of related applications)
This application claims the priority benefit of U.S. Patent Application No. 15 / 188,722 filed June 21, 2016, which application is hereby incorporated by reference in its entirety. To.

The art generally relates to humidifiers for ventilation and sputum assist systems.

Mechanical ventilators are used to assist in breathing. Traditional ventilators typically drive an inspiratory gas containing oxygen into the patient's lungs. Many patients who use a ventilator also require other types of assistance related to the treatment and maintenance of their airways and lungs, such as sputum assist. Currently, in order to receive sputum assist, the patient must be disconnected from the mechanical ventilator and connected to a separate sputum assist device. After the sputum assist is performed, the patient must be disconnected from the sputum assist device and reconnected to the mechanical ventilator. Often, the patient's airway is also to remove any residual secretions in the patient's airway after the patient has been disconnected from the sputum assisting device and reconnected to the mechanical ventilator. Be sucked. This process can often be ridiculous and is often not done in the manner that is most favorable to the patient.

Therefore, there is a need for a ventilator to provide additional functions other than delivering inspiratory gas into the patient's lungs, such as sputum assist and humidification. The present art provides these and other advantages that will become apparent from the embodiments and accompanying figures for carrying out the following inventions.

Patients on ventilators often require humidification of both the inspiratory gas provided to the patient and the inspiratory gas for assisted sputum therapy (also known as mechanical insufflation-exhaust). do. Equipping the ventilator with sputum assisting capacity eliminates the need to modify the patient circuit in order to transition between ventilation and sputum therapy. However, we have noticed that the high exhaust flow during sputum assist passing through the humidifier chamber causes moisture to return to the ventilator. To alleviate this problem, the technology allows the insufflation gas to pass through the humidifier chamber to the patient and, without passing through the humidifier chamber, to deliver the exhaust gas back to the ventilator, the humidifier bypass. Is targeted.

The purpose of the ventilator bypass is to redirect the exhaust flow around the humidifier chamber and prevent the exhaust flow from blowing the moisture in the chamber back into the ventilator. The bypass can be a passive accessory that connects to a standard commercial humidifier chamber. Bypass can remain in the line between the ventilator and the patient after sputum therapy. When ventilation resumes, the inhaled gas is delivered through the humidifier chamber as if there were no bypass.

In addition, the bypass may also be used by ventilator patients with a stand-alone sputum assisting machine. Typically, the patient circuit is disconnected in the patient to perform sputum therapy. A dedicated patient tube on the sputum discharge machine is then connected to the patient. When using invasive ventilation, the patient may experience discomfort when manipulating the tubes very close to the tracheostomy site and there is some risk of accidental extubation. Also, in this scenario, the humidified gas is no longer delivered to the patient until ventilation is resumed and the humidifier returns to the line. The humidifier bypass system according to an embodiment of the present invention allows the patient circuit to be disconnected at any location between the ventilator and the humidifier, rather than being disconnected in the patient. The humidified gas is therefore delivered during the intake, while the bypass prevents moisture from entering the sputum assisting machine from the humidifier during the exhaust.
The present invention provides, for example,:
(Item 1)
It ’s a system,
A sputum assisting device having a first phase configured to provide insufflation gas to the patient circuit and a second phase configured to draw exhaust gas out of the patient circuit.
A humidifier between the sputum assisting device and the distal end of the patient circuit, the humidifier comprising a chamber, the chamber containing heated water, said sputum assisting device and A humidifier configured to be fluidly coupled to the patient circuit,
A system comprising a bypass configured to deliver exhaust gas from the patient circuit to the ventilator such that the exhaust gas bypasses the chamber.
(Item 2)
The system of item 1, wherein the sputum assisting device comprises a ventilator configured to provide respiratory assist in a first mode and sputum assist in a second mode.
(Item 3)
The system of item 1, wherein the bypass is further configured to direct the insufflation gas from the ventilator through the patient circuit so that the insufflation gas is humidified in the chamber.
(Item 4)
The bypass is
(A) to open the air supply gas from the sputum discharge assisting device so as to pass through the chamber in the presence of the air supply gas, and (b) to prevent the exhaust gas from leaving the chamber. The first valve, which is configured to be closed in the presence of exhaust gas,
(A) The exhaust gas is opened in the presence of the exhaust gas from the patient circuit so that the exhaust gas does not pass through the chamber but passes through the ventilator, and (b) the presence of the air supply gas. The system according to item 3, comprising a second valve configured to do with closing below.
(Item 5)
The bypass is
A first conduit that extends away from the chamber and fluidly couples the ventilator to the chamber.
A second conduit that extends away from the chamber and fluidly couples the chamber to the distal end of the patient circuit.
A bridge that connects to and extends between the first and second conduits, wherein the bridge is separated from the chamber.
A first valve located in the first conduit at a position between the chamber and the bridge,
3. The system of item 3, comprising a second valve disposed within the bridge at a position between the first conduit and the second conduit.
(Item 6)
The first valve is a one-way valve configured to open towards the chamber in the presence of air supply gas, and the second valve is the first conduit in the presence of exhaust gas. 5. The system according to item 5, which is a one-way valve configured to open toward.
(Item 7)
It ’s a system,
A sputum assisting device comprising an insufflation module configured to provide an insufflation gas flow to the patient circuit and an exhaust module configured to draw an exhaust gas flow out of the patient circuit.
A humidifier that is fluidly coupled to the sputum assisting device and the patient circuit, wherein the humidifier has a chamber configured to contain heated water.
A bypass, wherein the bypass is a first flow path between the sputum assisting device and the chamber, a second flow path between the chamber and the patient circuit, and the first flow. The valve system has a path and a third flow path between the second flow path and the valve system.
(A) Blocking the third flow path during air supply so that the air supply gas flow passes through the chamber through the first and second flow paths.
(B) During the exhaust, the third flow path is opened and the first flow path is shut off so that the exhaust gas flow passes through the third flow path and bypasses the chamber. A system with a bypass that is configured to do things.
(Item 8)
The valve system
A first passive valve in the first flow path between the chamber and the intersection between the first flow path and the third flow path.
7. The system of item 7, comprising a second passive valve in the third flow path.
(Item 9)
The first passive valve comprises a first check valve configured to open towards the chamber during air delivery and the second passive valve said first during exhaust. 8. The system of item 8, comprising a second check valve configured to open towards the flow path.
(Item 10)
The valve system comprises a valve disposed within the first flow path at the intersection between the first flow path and the third flow path.
(A) Blocking the third flow path during air supply so that the air supply gas flow passes through the first flow path into the chamber.
(B) During the exhaust, the third flow path is opened and the first flow path is shut off so that the exhaust gas flow passes through the third flow path and bypasses the chamber. The system according to item 7, which is configured to do so.
(Item 11)
Humidifier assembly,
A chamber configured to hold the liquid in it,
A heater configured to deliver heat to the liquid in the chamber,
An insufflation flow path configured to receive the insufflation gas from the sputum drainage assisting device and direct the insufflation gas through the chamber to the patient circuit.
A humidifier assembly with an exhaust flow path that receives the exhaust gas from the patient circuit and is configured to direct the exhaust gas to the sputum assisting device without passing through the chamber.
(Item 12)
A first conduit extending away from the chamber and configured to fluidly couple the sputum assisting device to the chamber.
A second conduit extending away from the chamber and configured to fluidly couple the chamber to the patient circuit.
11. A bridge that connects to and extends between the first and second conduits, wherein the bridge further comprises a bridge that is separated from the chamber. Humidifier assembly.
(Item 13)
Further comprising a first valve located within the first conduit at a position between the chamber and the bridge.
The humidifier assembly according to item 12, wherein the air flow path passes through the first valve.
(Item 14)
13. The humidifier assembly according to item 13, wherein the exhaust flow path does not pass through the first valve.
(Item 15)
Further comprising a second valve located within the bridge at a position between the first conduit and the second conduit.
The humidifier assembly according to item 12, wherein the exhaust flow path passes through the second valve.
(Item 16)
The humidifier assembly according to item 15, wherein the air flow path does not pass through the second valve.
(Item 17)
A method for providing sputum assist to a patient, wherein the method is:
Delivering insufflation gas from the sputum assist device to the patient via the patient circuit,
A method of withdrawing an exhaust gas from the patient through the patient circuit, comprising bypassing the humidifier before the exhaust gas reaches the sputum assisting device.
(Item 18)
17. The method of item 17, wherein drawing the exhaust gas comprises providing a pressure of −30 to 70 cmH ₂ O into the patient circuit.
(Item 19)
Delivering the insufflation gas comprises passing the insufflation gas through a chamber in the humidifier, thereby humidifying the insufflation gas before reaching the patient. The method described.
(Item 20)
17. The method of item 17, wherein the extraction of the exhaust gas comprises passing the exhaust gas through a bypass coupled to the humidifier.
(Item 21)
The bypass is
(A) Opening while delivering the air supply gas so that the air supply gas from the sputum discharge assisting device passes through the chamber in the humidifier, and (b) in the presence of the exhaust gas. A first valve configured to perform closing to prevent exhaust gas from the chamber from exiting.
(A) opening the exhaust gas while drawing it from the patient circuit so that the exhaust gas does not pass through the chamber but through the ventilator, and (b) the presence of the insufflation gas. 20. The method of item 20, comprising a second valve configured to do with closing below.

FIG. 1 is a block diagram illustrating a system including a ventilator for use by a human patient.

FIG. 2A is a schematic diagram illustrating the components of the ventilator assembly of FIG. 1 with the ventilator assembly sputum assist valve depicted in the first configuration.

FIG. 2B is a schematic diagram illustrating the sputum assist valve of the ventilator assembly in the second configuration.

FIG. 3 illustrates a ventilation system, including a ventilator, with integrated sputum assist functionality, patient circuitry, a humidifier, and a humidifier bypass system.

4A-4D illustrate various diagrams of the humidifier bypass system. 4A-4D illustrate various diagrams of the humidifier bypass system. 4A-4D illustrate various diagrams of the humidifier bypass system. 4A-4D illustrate various diagrams of the humidifier bypass system.

5A and 5B illustrate cross-sectional views of another embodiment of the humidifier bypass system. 5A and 5B illustrate cross-sectional views of another embodiment of the humidifier bypass system.

Further specific details of some embodiments of the present art will be described below with reference to FIG. 1-5B. Many of the embodiments are described below with respect to devices, systems, and methods for ventilation with humidified sputum assist, but other embodiments are also within the scope of the art. In addition, other embodiments of the technique may have configurations, components, and / or procedures different from those described herein. For example, other embodiments may include additional elements and features other than those described herein, or other embodiments may include a number of elements and features illustrated and described herein. It does not have to include.

For ease of reference, the same reference number is used throughout the disclosure to identify similar or similar components or features, but the components identified by the same reference number are not necessarily the same. is not it. In fact, in many of the embodiments described herein, similarly numbered parts are distinctly different in structure and / or function.

FIG. 1 is a block diagram illustrating a system 10 including a ventilator 100 with integrated humidified sputum assist according to an embodiment of the technique. Some general aspects of the system 10 will first be described to provide an understanding of the components associated with embodiments of the humidified bypass device of the present invention. The ventilator 100 may be configured to provide both conventional metered ventilation and pressure controlled ventilation. The ventilator 100 has a voluntary multicavity tube connection 103, a primary ventilator connection 104, and a patient oxygen outlet 105. The system 100 also fluidizes the patient connection 106 (eg, tracheal tube, nasal mask, mouthpiece, and equivalent) with the patient connection 106 and the primary ventilator connection 104 and / or the patient oxygen outlet 105. It has a patient circuit 110 that couples to.

The patient circuit 110 may be an active patient circuit or a passive patient circuit. Optionally, when the patient circuit 110 is an active patient circuit, the patient circuit 110 may include one or more ports 111 configured to be connected to a voluntary multicavity tube connection 103. .. Port 111 allows one or more pressure signals 109 to flow between the optional multicavity tube connection 103 and the patient circuit 110. The pressure signal 109 may be a gas obtained from a fluid (and / or gas) source from which the pressure will be measured. The acquired gas is at the same pressure as the fluid (and / or gas) source.

The system 100 further includes a humidifier 141 in line with the patient circuit 110 and the primary ventilator connection 104. In some embodiments, the patient circuit 110 extends between the humidifier 141 and the patient connection 106, in addition to a tube or conduit, between the humidifier 141 and the primary ventilator connection 104. Includes extending pipes or conduits. The system 100, more specifically the humidifier 141, can be equipped with a bypass 142, as described in more detail below.

The primary ventilator connection 104 is configured to provide a gas 112 that includes air 114 that is optionally mixed with oxygen. Although identified as "air," one of ordinary skill in the art will appreciate that the air 114 may include ambient air or pressurized air obtained from any source external to the ventilator 100. The gas 112 may be an inspiratory gas for the inspiratory phase of respiration or an inspiratory gas for the sputum assisting inspiratory phase. The primary ventilator connection 104 is configured to receive gas 113, which may include exhaust gas exhaled by patient 102, during the exhaust phase of sputum assist.

The air 114 is received by the ventilator 100 through the patient air intake 116. Oxygen, optionally mixed with air 114, is generated internally by the ventilator 100 and / or received from an optional low pressure oxygen source 118 (eg, an oxygen concentrator) and / or an optional high pressure oxygen source 120. May be done. When oxygen is generated internally, the ventilator 100 may output exhaust gas (eg, nitrogen-rich gas 122) through the outlet vent 124. Optionally, the ventilator 100 may include a low pressure oxygen inlet 126 that is coupled to and is configured to receive the optional low pressure oxygen 128 from the optional low pressure oxygen source 118. The ventilator 100 may include an optional high pressure oxygen inlet 130 that is coupled to and is configured to receive the optional high pressure oxygen 132 from the optional high pressure oxygen source 120.

The patient oxygen outlet 105 is configured to provide a dose or pulse of oxygen 140 to the patient connection 106, which is synchronized with the patient's breathing, via the patient circuit 110. Unlike the gas 112 provided by the main ventilator connection 104, the pulse of oxygen 140 does not contain air 114.

The gas 112 and / or pulse of oxygen 140 delivered to the humidifier 141 and the patient circuit 110 is thereby conducted to the patient connection 106 as inspiratory or inspiratory gas 108, which, at least in part, they. Gas is conducted into the patient's lungs 143. Each time the patient exhales during the exhalation phase of breathing, during the exhalation phase, or during the sputum assisting exhaust phase, the exhaled gas 107 enters the patient circuit 110 via the patient connection 106. Thus, the patient circuit 110 may contain one or more of the following gases: the gas 112 provided by the ventilator 100, the pulse of oxygen 140, and the exhaled gas 107. For ease of illustration, the gas inside the patient circuit 110 will be hereafter referred to as "patient gas".

The ventilator 100 can optionally include an inhalation connection 150 configured to be coupled to the optional inhalation assembly 152. The ventilator 100 may provide the suction input 154 to the optional inhalation assembly 152 via the optional inhalation connection 150. The inhalation assembly 152 may be configured to be connected to a patient connection 106, an inhalation catheter (not shown) that can be located inside the patient connection 106, and / or a drain (not shown).

The ventilator 100 may additionally include a voluntary nebulizer connection 160 configured to be coupled to the voluntary nebulizer assembly 162. The ventilator 100 may provide gas 164 (eg, air 114) to the optional nebulizer assembly 162 via the optional nebulizer connection 160. The optional nebulizer assembly 162 may be configured to be connected to the patient circuit 110. However, this is not a requirement. Optionally, the ventilator 100 may include an outlet port 166 through which the exhaust gas 167 can exit the ventilator 100.

The ventilator 100 is portable and may be configured to be powered by an internal battery (not shown) and / or an external power source (not shown) such as a conventional wall outlet. The ventilator 100 further includes a ventilation assembly 190, a user interface 170, an oxygen assembly 172, a control system 174, and a conventional monitoring and alarm system 176. The control system 174 receives input information 196 (eg, settings, parameter values, and equivalents) from user interface 170 and provides output information 198 (eg, performance information, status information, and equivalents) to user interface 170. do. The user interface 170 is configured to receive inputs from users (eg, caregivers, clinicians, and equivalents associated with patient 102) and provide the inputs to control system 174 within input information 196. .. The user interface 170 is also configured to display the output information 198 to the user.

The ventilation assembly 190 may receive one or more control signals 192 from the control system 174, and the ventilation assembly 190 may provide one or more data signals 194 to the control system 174. The ventilation assembly 190 may also receive a pressure signal 109 from the patient circuit 110 via the multicavity connection 103. The oxygen assembly 172 may receive one or more control signals 178 from the control system 174, and the oxygen assembly 172 may provide one or more data signals 180 to the control system 174. The control signals 192 and 178 and the data signals 194 and 180 may be used by the control system 174 to monitor and / or control the internal operation of the ventilator 100.

2A and 2B are schematic views illustrating embodiments of the ventilation assembly 190, the humidifier 141, and the bypass system 242. Referring to FIGS. 2A and 2B, the ventilation assembly 190 includes a sputum assist valve 204, an accumulator 202 and an internal bacterial filter 230. The sputum assist valve 204 is primarily ventilated by (a) conduit or flow line 214 to the accumulator 202, (b) by conduit or flow line 215 to outlet port 166, and (c) by conduit or flow line 273. It is connected to the accumulator connection unit 104. FIG. 2A depicts the sputum assist valve 204 in the first configuration for the normal breathing and sputum assisted air supply phase, and FIG. 2B shows the drainage in the second configuration for the sputum assisted exhaust phase. The sputum assist valve 204 is depicted.

Referring to FIG. 2A, in the first configuration, the sputum assist valve 204 receives the gas 252 from the accumulator 202 (via the flow line 214) and outputs the gas 252 to the main ventilator connection 104 (via the flow line 214). Via flow line 273). The gas 252 flows through both the blower 222 and the sputum assist valve 204 during the inspiratory phase of breathing or the air supply phase of the sputum assisting operation performed by the ventilator 100 (see FIG. 1). During the normal breathing / ventilation and sputum assist air delivery phases, the sputum assist valve 204 remains in the first configuration. The typical pressure range normally used to support breathing and ventilation can be about 10-40 cmH ₂ O during inspiration and about 0-10 cmH ₂ O during exhalation. During the sputum discharge assist, the sputum discharge assist valve 204 is in the first configuration (FIG. 2A) during the air supply phase and in the second configuration (FIG. 2B) during the exhaust phase. Typical pressure ranges used to provide sputum assist functionality are generally about 30-70 cmH _{2 O during insufflation, between about -30-70 cmH 2 O} , etc. during normal breathing / ventilation. taller than.

The sputum discharge auxiliary valve 204 has a valve / blower outlet 206, a blower / valve inlet 208, an air intake port 210, an exhaust gas outlet 212, and an opening 213. The opening 213 is connected to the main ventilator connection 104 by a flow line 273. As shown in FIG. 2A, when the sputum drainage assist valve 204 is in the first configuration, the air intake 210 communicates fluid with the valve / blower outlet 206 and the blower / valve inlet 208 opens 213. And fluid communication. Further, the exhaust gas outlet 212 is closed so that both the valve / blower outlet 206 and the air intake port 210 communicate with the opening 213 only through the blower 222. Thus, the gas 252 can flow into the air intake 210, through a portion of the sputum assist valve 204, to the valve / blower outlet 206, and into the blower 222. The gas 252 exiting the blower 222 flows into the blower / valve inlet 208, through another portion of the sputum assist valve 204, and into the opening 213. The opening 213 is connected to the flow line 273, which conducts the gas 252 to the main ventilator connection 104.

During inspiration or insufflation, gas 252 passes through the main ventilator connection 104, across the bacterial filter 230 and into the bypass system 242. In the embodiment shown in FIG. 2A, the bypass system 242 has a first valve 244 and a second valve 246 coupled to the humidifier 141. During normal breathing / ventilation and insufflation, the gas 252 flows through the first valve 244 into the humidifier 141, where it is humidified. The gas 252 is then passed through the output of the bypass system 242 to the patient circuit 110. The second valve 246 of the bypass system 242 prevents the gas 252 from first passing directly into the patient circuit 110 without traveling through the humidifier 141. The operation of the bypass system 242 is described in more detail below with respect to FIG. 3-5B.

Referring to FIG. 2B, in the second configuration, the sputum assist valve 204 receives the exhaust gas 253 via the flow line 273, and the exhaust gas 253 (as the exhaust gas 167) is provided with the flow line 215 at the outlet port 166. Output via. The exhaust gas 253 flows through both the blower 222 and the sputum assist valve 204 during the sputum assist exhaust phase implemented by the ventilator 100 (see FIG. 1).

As shown in FIG. 2B, when the sputum assist valve 204 is in the second configuration, the air intake 210 is closed and the blower / valve inlet 208 and exhaust gas outlet 212 only use the blower 222. Through, fluid communication with the opening 213. Further, the opening 213 communicates fluid with the valve / blower outlet 206, and the blower / valve inlet 208 communicates fluid with the exhaust gas outlet 212. Therefore, the exhaust gas 253 flows into the opening 213, across a portion of the sputum assist valve 204, to the valve / blower outlet 206, and into the blower 222. The exhaust gas 253 discharged from the blower 222 flows into the blower / valve inlet 208 through a part of the sputum auxiliary valve 204, and exits from the sputum auxiliary valve 204 through the exhaust gas outlet 212. The exhaust gas outlet 212 is connected to the flow line 215, which conducts the exhaust gas 253 to the outlet port 166.

During exhaust, the gas 253 passes through the patient circuit 110, through the second valve 246 of the bypass system 242, and across the bacterial filter 230 before reaching the primary ventilator connection 104. The second valve 246 of the bypass system 242 allows the gas 253 to pass through the main ventilator connection 104, while the first valve 244 of the bypass system 242 allows the gas 253 to pass through the humidifier 141. Prevent it from returning. For example, the first valve 244 closes during the exhaust flow to prevent the gas 253 from returning through the humidifier 141 to the main ventilator connection 144. As a result, the high speed exhaust gas 253 cannot accompany the liquid from the humidifier 141 into the flow of gas 253 returning into the ventilator 100. The operation of the bypass system 242 is described in more detail below with respect to FIG. 3-5B.

FIG. 3 illustrates a system 300, including a ventilator 100 with integrated sputum assist functionality coupled to a patient circuit 110 and a humidifier 141 equipped with an embodiment of a bypass system 242. .. As shown, this embodiment of the humidifier 141 and bypass system 242 is aligned with the patient circuit 110. The patient circuit 110 includes a first tube 301 connected to one side of the bacterial filter 230 and the bypass system 242 and a second tube 303 connected to the other side of the bypass system 242. The distal end 305 of the second tube 303 can be connected to the patient connection 106 (FIG. 1).

The humidifier 141 includes a base 307 with an integrated heater and a chamber 309 configured to hold water. During operation, the base 307 heats the water in the chamber 309 to produce steam. As a result, the inspiratory and inspiratory gases passing through chamber 309 are humidified before being delivered to the patient.

The bypass system 242 fluidly communicates with the first tube 301 and the second tube 303 of the chamber 309 and the patient circuit 110. In particular, the bypass system 242 includes a first conduit 311 extending between the chamber 309 of the humidifier 141 and the first tube 301 of the patient circuit 110. The bypass system 242 additionally includes a second conduit 313 extending between the chamber 309 of the humidifier 141 and the second tube 303 of the patient circuit 110. The bypass system 242 can also include a bridge 315 fluidly coupled to and extending between the first conduit 311 and the second conduit 313 at a position separated from the chamber 309.

The first valve 244 is located within the first conduit 311 at a position below the intersection of the bridge 315 and the first conduit 311. The first valve 244 is configured to open when the pressure in the chamber 309 is higher than the first tube 301, but close when the pressure in the chamber 309 is higher than the first tube 301. Can be a directional valve. Therefore, during inspiration or insufflation, gas flows from the ventilator 100, from the first tube 301 of the patient circuit 110, through the first conduit 311 and through the first valve 244, through the chamber 309 of the humidifier 141. Flow in. However, during exhalation or exhaust, gas is prevented from flowing back through chamber 309 to first conduit 311.

The second valve 246 is located within the bridge 315 of the bypass system 242. The second valve 246 is a ventilator during which gas from the patient flows from the second tube 303 of the patient circuit 110 through the second conduit 313, through the bridge 315, and through the second valve 246. It can be a one-way valve configured to open towards the first conduit 311 so as to flow towards 100. Therefore, the opposing unidirectional and positional positions of the first and second valves 244 and 246 direct the high speed exhaust stream towards the ventilator 100 without passing through the humidifier 141.

The first and second valves 244 and 246 can be many different types of valves. For example, ball check valves, diaphragm check valves, leaf valves, swing check valves, where one or both of the valves 244 and 246 allow flow in one direction but not in the opposite direction. It can be a tilted disc check valve, a clamper valve, or any other suitable valve. The first and second valves 244 and 246 can be passive valves configured to open in the presence of flow in one direction without the need for operation. In other embodiments, one or both of the valves can be active valves that are electronically controlled to open and close in response to signals communicated from the controller (see FIG. 5).

The system 300 provides a first flow path 317 through the bypass system 242. The first flow path 317 receives gas flowing from the ventilator 100 through the first tube 301 of the patient circuit 110 into the first conduit of the bypass system 242. The first valve 244 opens in the presence of gas flowing in the direction of the first flow path 317, while the second valve 246 is closed. The first flow path 317 therefore continues through the first valve 244 and through the chamber 309 of the humidifier 141 into the second conduit 313 of the bypass system 242. The first flow path 317 delivers the gas into the second tube 303 of the patient circuit 110 and then passes through the distal end 305 of the patient circuit 110 to the patient. In this first flow path 317, the gas (eg, the gas provided by the ventilator 100 in either breathing assist (inspiratory) or sputum assisting (air supply) mode) is at the distal end of the patient circuit 110. It reaches 305 and is humidified before being delivered to the patient.

The system 300 also provides a second flow path 319 through the bypass system 242. The second flow path 319 receives gas flowing from the distal end 305 of the patient circuit 110 through the second tube 303 of the patient circuit into the second conduit 313 of the bypass system 242. The first valve 244 remains closed in the presence of gas flowing in the direction of the second flow path 319, while the second valve 246 is opened. As a result, the second flow path 319 continues through the bridge 315 and through the first conduit 311 of the bypass system 242. The second flow path 319 delivers the gas into the first tube 301 of the patient circuit 110 and then passes through the bacterial filter 230 into the ventilator 100. In the second flow path 319, gas (eg, exhaust gas drawn from the patient during sputum assist) does not pass through chamber 309 of the humidifier 141. As a result, the risk of liquid from chamber 309 passing through the first tube 301 of the patient circuit 110 into the bacterial filter 230 and / or the ventilator 100 is reduced.

4A-4D illustrate various diagrams of embodiments of the bypass system 242 coupled to the humidifier chamber 309. 4A is a perspective view, FIG. 4B is a partially exploded view, FIG. 4C is a side view, and FIG. 4D is a cross section obtained along line 4D-4D in FIG. 4C. It is a figure. With reference to FIGS. 4A-4D together, the bypass system 242 can be configured to engage chamber 309, which is coupled to a standard commercially available humidifier base. Once coupled to the humidifier base, the liquid in chamber 309 can be heated. Chamber 309 includes a body 401 with a first stem 403 and a second stem 405 projecting from the body 401 in the embodiment shown in FIGS. 4A-4D. The first conduit 311 of the bypass system 242 engages the first stem 403 of chamber 309, and the first valve 244 passes through the first conduit 311 and through the first stem 403 of chamber 309. The gas passing through the body 401 is in the first conduit 311 so that it must pass through the first valve 244. As described above with respect to FIG. 3, the first conduit 311 of the bypass system 242 connects to the first tube 301 of the patient circuit 110, which delivers gas to and from the ventilator 100.

The second conduit 313 of the bypass system 242 couples to the second stem 405 of chamber 309. As mentioned above, the second conduit 313 of the bypass system 242 connects to the second tube 303 of the patient circuit 110, which connects to the patient connector and delivers gas to and from the patient. The bridge 315 extends between the first conduit 311 and the second conduit 313 of the bypass system 242, and the second valve 246 is in the bridge 315.

The bypass system 242 can also have a refill port 407 coupled to a second stem 405 of chamber 309. The refill port 407 can share a portion of the tubes with the second conduit 313 so that the liquid can be delivered to the chamber 309 through the refill port 407. In another embodiment, chamber 309 can be filled through a separate port.

5A and 5B illustrate cross-sectional views of another embodiment of the humidifier bypass system 501 according to the present technology. The bypass system 501 may generally resemble the bypass system 242, which is the system illustrated in FIGS. 4A-4D, but the bypass system 501 is a controller integrated within the control system 174 described above with respect to FIG. Includes a single controllable valve 503 coupled to 505. The valve 503 can be moved between a first position (FIG. 5A) and a second position (FIG. 5B) in response to a signal received from the controller 505. In the first position (FIG. 5A), the valve 503 allows the inspiratory or inspiratory gas to pass through the first conduit 311 and through the first stem 403 into chamber 309, where. The gas is humidified prior to exiting the patient via the second stem 405 and the second conduit 313. In the second position (FIG. 5B), the valve 503 does not allow the exhaust gas to pass through the chamber 309, but through the second conduit 313, across the bridge 315, and through the first conduit 311. Enables. When the valve 503 is in the second position, the liquid in chamber 309 is blocked from flowing back into the ventilator. The single controllable valve 503 therefore provides similar functionality to the two-valve system described above with respect to FIG. 3-4D.
Additional Examples 1. It ’s a system,
A sputum assisting device having a first phase configured to provide insufflation gas to the patient circuit and a second phase configured to draw exhaust gas out of the patient circuit.
A humidifier between the sputum assisting device and the distal end of the patient circuit, the humidifier comprises a chamber, the chamber containing heated water and fluid to the sputum assisting device and the patient circuit. A humidifier, which is configured to be combined with,
A system with a bypass configured to deliver the exhaust gas from the patient circuit to the ventilator so that the exhaust gas bypasses the chamber.
2. 2. The system according to Example 1, wherein the sputum assisting device comprises a ventilator configured to provide respiratory assist in a first mode and sputum assist in a second mode. 3. 3. The bypass is further described in any one of Examples 1-2 configured to direct the insufflation gas from the ventilator through the patient circuit so that the insufflation gas is humidified in the chamber. System.
4. Bypass is
(A) Exhaust gas from the sputum assist device to pass through the chamber and open in the presence of air gas, and (b) Exhaust gas to prevent it from leaving the chamber. The first valve, which is configured to close in the presence of gas,
(A) Open in the presence of exhaust from the patient circuit and (b) Close in the presence of insufflation so that the exhaust does not pass through the chamber but through the ventilator. The system according to Example 3, comprising a second valve configured to do so.
5. Bypass is
With a first conduit that extends away from the chamber and fluidly connects the ventilator to the chamber,
A second conduit that extends away from the chamber and fluidly connects the chamber to the distal end of the patient circuit.
A bridge that connects to and extends between the first and second conduits, the bridge being separated from the chamber, with the bridge.
A first valve located in the first conduit at the position between the chamber and the bridge,
The system according to Example 3, comprising a second valve located within the bridge at a position between the first conduit and the second conduit.
6. The first valve is a one-way valve configured to open towards the chamber in the presence of air supply gas and the second valve opens towards the first conduit in the presence of exhaust gas. The system according to Example 5, which is a one-way valve configured to.
7. It ’s a system,
A sputum assisting device comprising an air supply module configured to provide an air supply gas flow to the patient circuit and an exhaust module configured to draw an exhaust gas flow out of the patient circuit.
A humidifier that is fluidly coupled to a sputum assist device and a patient circuit, the humidifier having a chamber configured to contain heated water, and a humidifier.
Bypass is a first flow path between the sputum assisting device and the chamber, a second flow path between the chamber and the patient circuit, a first flow path and a second flow path. The valve system has a third flow path between the path and the valve system.
(A) Blocking the third flow path during the air supply so that the air supply gas flow passes through the chamber through the first and second flow paths.
(B) To open the third flow path and shut off the first flow path during the exhaust so that the exhaust gas flow passes through the third flow path and bypasses the chamber. Bypass and
The system.
8. The valve system
The first passive valve in the first flow path between the chamber and the intersection between the first flow path and the third flow path,
The second passive valve in the third flow path,
7. The system according to the seventh embodiment.
9. The first passive valve comprises a first check valve configured to open towards the chamber during insufflation and the second passive valve towards the first flow path during exhaust. 8. The system of Example 8, comprising a second check valve configured to open.
10. The valve system comprises a valve that is located within the first flow path at the intersection between the first flow path and the third flow path.
(A) Blocking the third flow path during the air supply so that the air supply gas flow passes through the first flow path into the chamber.
(B) To open the third flow path and shut off the first flow path during the exhaust so that the exhaust gas flow passes through the third flow path and bypasses the chamber. The system according to any one of Examples 7-9, configured in.
11. Humidifier assembly,
A chamber configured to hold the liquid in it,
A heater configured to deliver heat to the liquid in the chamber,
An insufflation flow path configured to receive the insufflation gas from the sputum assist device and direct the insufflation gas through the chamber to the patient circuit.
A humidifier assembly with an exhaust flow path that is configured to receive the exhaust gas from the patient circuit and direct the exhaust gas to the sputum assist device without passing through the chamber.
12. A first conduit that extends away from the chamber and is configured to fluidly connect the sputum assisting device to the chamber.
A second conduit that extends away from the chamber and is configured to fluidly connect the chamber to the patient circuit.
The humidifier assembly according to Example 11, wherein the bridge is a bridge that connects to and extends between the first and second conduits, the bridge further comprising a bridge that is separated from the chamber. ..
13. Further comprising a first valve located within the first conduit at a position between the chamber and the bridge.
The humidifier assembly according to Example 12, wherein the air flow path passes through the first valve.
14. The humidifier assembly according to Example 13, wherein the exhaust flow path does not pass through the first valve.
15. Further comprising a second valve located within the bridge at a position between the first and second conduits.
The humidifier assembly according to any one of Examples 12-14, wherein the exhaust flow path passes through a second valve.
16. The humidifier assembly according to Example 15, wherein the air flow path does not pass through the second valve.
17. It is a method for providing sputum assistance to patients, and the method is
Delivering insufflation gas from the sputum assist device to the patient via the patient circuit,
Exhaust gas is drawn from the patient through the patient circuit, and the exhaust gas bypasses the humidifier before reaching the sputum assist device.
Including, how.
18. The method of Example 17, wherein drawing the exhaust gas comprises providing a pressure of -30 to 70 cmH ₂ O into the patient circuit.
19. Delivery of the insufflation gas involves any of Examples 17-18, comprising passing the insufflation gas through a chamber in a humidifier, thereby humidifying the insufflation gas before reaching the patient. The method according to item 1.
20. 13. The method of any one of Examples 17-19, wherein the extraction of the exhaust gas comprises passing the exhaust gas through a bypass coupled to a humidifier.
21. Bypass is
(A) Opening while delivering the insufflation gas so that the insufflation gas from the sputum assist device passes through the chamber in the humidifier, and (b) in the presence of the exhaust gas, from the chamber. A first valve configured to do so to prevent the exhaust gas from exiting, and
(A) Opening while drawing the exhaust gas from the patient circuit so that the exhaust gas passes through the ventilator without passing through the chamber, and (b) closing in the presence of the insufflation gas. A second valve configured to do
20. The method according to Example 20.

The embodiments of the art for carrying out the aforementioned inventions are not intended to be comprehensive or to limit the art to the precise embodiments disclosed above. Specific embodiments and examples of the present art are described above for illustrative purposes, but various equivalent modifications are considered possible within the scope of the present art to be recognized by those of skill in the art. .. For example, the steps are presented in a given order, but alternative embodiments may carry out the steps in a different order. The various embodiments described herein may also be combined to provide additional embodiments.

From the above, specific embodiments of the present technology are described herein for illustrative purposes, but well-known structures and functions avoid unnecessarily obscuring the description of embodiments of the present technology. Please understand that it is not illustrated or described in detail. Where possible by context, singular or plural terms may also include plural or singular terms, respectively.

Further, unless the word "or" is explicitly restricted to refer to a list of two or more items to mean only a single item that is exclusive to other items, within such a list. The use of "or" should be construed to include (a) any single item in the list, (b) all of the items in the list, or (c) any combination of items in the list. be. In addition, the term "with" is meant to include at least the listed features throughout so that any higher number of identical features and / or other features of the additional type are not excluded. Used for. Also, although specific embodiments have been described herein for illustrative purposes, it should be appreciated that various modifications may be made without departing from the art. Further, although the advantages associated with certain embodiments of the present invention have been described in the context of those embodiments, other embodiments may also exhibit such advantages, and all embodiments may not necessarily exhibit such advantages. It is not necessary to exhibit such an advantage because it is within the scope of the present technology. Accordingly, the disclosed and associated techniques may also include other embodiments not expressly illustrated or described herein.

Claims (18)

Humidifier assembly,
With a chamber configured to hold the liquid in it,
A heater configured to deliver heat to the liquid in the chamber, and
A first flow path configured to receive gas from the ventilator and direct the gas through the chamber towards the patient circuit.
With a second flow path configured to receive the gas from the patient circuit and direct the gas towards the ventilator without passing through the chamber.
A humidifier assembly. The first flow path is an intake flow path configured to receive inspiratory gas from the ventilator, and the second flow path is configured to receive exhaled gas from the patient circuit. The humidifier assembly according to claim 1, which is an exhalation flow path. The first flow path has (1) a first conduit extending away from the chamber and configured to fluidly couple the ventilator to the chamber, and (2) said. Includes a second conduit that extends away from the chamber and is configured to fluidly couple the chamber to the patient circuit.
The second flow path connects the first conduit and the second conduit and includes a third conduit extending between the first conduit and the second conduit, said first. The humidifier assembly of claim 1, wherein the conduit of 3 is separated from the chamber. Further comprising a first valve located within the first conduit at a position between the chamber and the third flow conduit.
The humidifier assembly according to claim 3, wherein the first flow path passes through the first valve. The humidifier assembly according to claim 4, wherein the second flow path does not pass through the first valve. Further comprising a second valve located within the third conduit at a position between the first conduit and the second conduit.
The humidifier assembly according to claim 3, wherein the second flow path passes through the second valve. The humidifier assembly according to claim 6, wherein the first flow path does not pass through the second valve. Humidifier assembly,
With a chamber configured to contain liquids,
A first conduit extending away from the chamber, the first conduit configured to receive gas from the ventilator and direct the gas towards the chamber.
A second conduit extending away from the chamber, configured to receive gas from the chamber and direct the gas towards the patient circuit.
A third conduit extending between the first conduit and the second conduit, wherein the third conduit is a third conduit that bypasses the chamber.
The humidifier assembly is configured to direct gas received from the patient towards the ventilator through the third conduit that bypasses the chamber. The humidifier assembly according to claim 8, wherein the humidifier assembly is configured to deliver gas received from the ventilator through the first conduit, the chamber, and the second conduit. .. Further comprising a valve system, the valve system is configured to prevent gas received from the ventilator from passing through the third conduit, a first valve in the third conduit. When,
With a second valve in the first conduit configured to prevent the gas received from the patient from being delivered towards the ventilator.
The humidifier assembly according to claim 8. The humidifier assembly is configured such that the gas received from the ventilator passes through the second valve and the gas received from the patient passes through the first valve. 10. The humidifier assembly according to 10. The humidification according to claim 8, wherein the gas received from the patient is an exhaust gas received during the sputum assisting exhaust phase or an exhaled gas received during the expiratory phase of respiration. Vessel assembly. It ’s a system,
A ventilator having a first phase and a second phase, in which in the first phase gas is directed from the ventilator towards the distal end of the patient circuit and the second phase. In the phase, with the ventilator, the gas is directed from the distal end of the patient circuit towards the ventilator.
A humidifier assembly between the ventilator and the distal end of the patient circuit, the humidifier assembly.
With a chamber configured to contain liquids,
A first flow path that fluidly connects the chamber and the ventilator,
A second flow path that fluidly connects the chamber and the distal end of the patient circuit,
A third flow path that connects the first flow path and the second flow path and extends between the first flow path and the second flow path.
The third flow path bypasses the chamber with a humidifier assembly.
The humidifier assembly delivers (1) gas from the ventilator towards the distal end of the patient circuit through the first and second channels. The gas delivered from the ventilator to the distal end of the patient circuit is humidified in the chamber, and (2) the gas is ventilated from the distal end of the patient circuit to the ventilator. It is configured to deliver through the third flow path towards the ventilator so that the gas delivered from the distal end of the patient circuit to the ventilator bypasses the chamber. The system. 13. The ventilator is configured to provide respiration, wherein the first phase is the inspiratory phase of the respiration and the second phase is the expiratory phase of the respiration. System. The ventilator is configured to provide sputum excretion, wherein the first phase is the sputum delivery phase and the second phase is the sputum exhaust phase. Item 13. The system according to item 13. The first flow path is a first conduit that extends away from the chamber and includes a first conduit that is configured to fluidly couple the ventilator to the chamber. ,
The second flow path is a second conduit that extends away from the chamber and is configured to fluidly connect the chamber to the distal end of the patient circuit. Including the conduit of
The third flow path is a third conduit connecting the first conduit and the second conduit, and is a third conduit extending between the first conduit and the second conduit. 13. The system of claim 13, wherein the third conduit is separated from the chamber. The humidifier assembly further comprises a valve system, which is a valve system.
A first valve configured to block the third flow path as gas is delivered from the ventilator towards the distal end of the patient circuit.
With a second valve configured to block the first flow path as gas is delivered from the distal end of the patient circuit towards the ventilator.
13. The system according to claim 13. The first valve comprises a first check valve configured to open towards the ventilator and the second valve opens towards the distal end of the patient circuit. 17. The system of claim 17, comprising a second check valve configured to do so.

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